仲景方药辨治抑郁症研究进展  

Research Progress of ZHANG Zhong-jing’s Classical Formulae in Treatment of Depression

作　　者：李耀洋 尚立芝 许二平[2,3] LI Yao-yang;SHANG Li-zhi;XU Er-ping(The First Clinical School of Henan University of Chinese Medicine,Zhengzhou 450006,China;Henan Key Laboratory for Modern Research of Zhongjing Compound Traditional Chinese Medicine,Zhengzhou 450046,China;Academy of Chinese Medical Sciences,Henan University of Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学第一临床医学院,郑州450006 [2]河南省仲景方药现代研究重点实验室,郑州450046 [3]河南中医药大学中医药科学院,郑州450046

出　　处：《中国实验方剂学杂志》2020年第23期1-11,共11页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81973739);河南省高等学校重点科研项目(20B360011);国家级大学生创新创业训练计划支持项目(202010471003,202010471016)。

摘　　要：抑郁症是一种情感精神障碍性疾病,与单胺类神经递质代谢异常、免疫炎症反应、神经内分泌紊乱等诸多发病因素有关,具有高致残率和高复发率的特点,严重危害人类健康,为患者及其家庭带来了巨大的经济负担。目前临床上常用的抗抑郁药物主要有单胺氧化酶抑制剂、三环类抗抑郁药、选择性5-羟色胺(5-HT)再摄取抑制剂,长期服用引起心血管、泌尿、消化功能异常等不良反应。中医药多靶点、多途径、多机制的作用方式在抑郁症的治疗与康复过程中发挥了极大的作用,同时中药以其副作用小、用药依从性好等优点逐渐成为抗抑郁药研发的热点。尤其是用药精专、组方严谨的仲景方药在治疗抑郁症方面具有独特优势,数千年来已被无数医家在临床上应用于治疗各种类型的抑郁症,疗效确切。近年来,围绕仲景方药治疗抑郁症的临床研究、实验研究和药理学研究不断扩展和深化。该文将从柴胡类方、栀子类方和其他方3个方面揭示仲景方药辨治抑郁症的用药规律,着重体现在对方剂组成、病因病机和主治症状的探讨。其次,整合归类了仲景方药在抑郁症治疗方面的经验,主要从临床研究和药理研究2个方面进行阐述。进而概括了近年来仲景方药治疗抑郁症的研究角度和进展程度,以期能够挖掘、传承和发展仲景方药及为多角度、多思路地治疗抑郁症提供经验和借鉴。Depression is a kind of emotional and mental disorder,which is related to many pathogenic factors, such as abnormal metabolism of monoamine neurotransmitters, immune inflammatory reaction,neuroendocrine disorder and so on. it has the characteristics of high disability rate and high recurrence rate,which is seriously harmful to human health. It brings huge economic burden to patients and their families. At present,the commonly used antidepressants in clinic are monoamine oxidase inhibitors,tricyclic antidepressants and selective 5-hydroxytryptamine reuptake inhibitors. Long-term use causes adverse reactions such as cardiovascular,urinary and digestive dysfunction. The multi-target,multi-pathway and multi-mechanism of traditional Chinese medicine has played a great role in the treatment and rehabilitation of depression. At the same time, traditional Chinese medicine has gradually become a hot spot in the research and development of antidepressants because of its small side effects and good drug compliance. Especially the ZHANG Zhong-jing’s classical formulae with precise medication and rigorous prescription has unique advantages in the treatment of depression. For thousands of years,it has been used clinically by countless doctors in the treatment of various types of depression,with definite curative effects and few side effects. In recent years,clinical research,experimental research, and pharmacological research around ZHANG Zhong-jing’s classical formulae for depression have been continuously expanded and deepened. This article reveals the rules of medication of the treatment of depression with ZHANG Zhong-jing’s classical formulae from three aspects of Bupleurum class prescription, Gardenia class prescription, and other prescriptions, which is reflected in the study on the composition of prescription,the etiology,and pathogenesis and the symptoms of the treatment. Integrating and classifying ZHANG Zhong-jing’s classical formulae’s experience in the treatment of depression, mainly expounded from two as

关 键 词：仲景方药 抑郁症 研究进展 柴胡类方 栀子类方 

分 类 号：R2-0[医药卫生—中医学] R289